Nokea
Several residents of a long-term care facility have developed signs and symptoms of viral conjunctivitis. What is the most appropriate action of the nurse who oversees care in the facility?
- A. Arrange for the administration of prophylactic antibiotics to unaffected residents.
- B. Instill normal saline into the eyes of affected residents two to three times daily.
- C. Swab the conjunctiva of unaffected residents for culture and sensitivity testing.
- D. Isolate affected residents from residents who have not developed conjunctivitis.
Correct Answer: D
Rationale: Isolating affected residents prevents the spread of viral conjunctivitis. Antibiotics, saline flushes, and swabbing unaffected residents are ineffective or unnecessary.
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A patient is ready to be discharged home after a cataract extraction with intraocular lens implant and the nurse is reviewing signs and symptoms that need to be reported to the ophthalmologist immediately. Which of the patients statements best demonstrates an adequate understanding?
- A. I need to call the doctor if I get nauseated.
- B. I need to call the doctor if I have a light morning discharge.
- C. I need to call the doctor if I get a scratchy feeling.
- D. I need to call the doctor if I see flashing lights.
Correct Answer: D
Rationale: Flashing lights may signal retinal detachment, requiring immediate reporting post-cataract surgery. Nausea, mild discharge, and scratchiness are less concerning.
A patient has just arrived to the floor after an enucleation procedure following a workplace accident in which his left eye was irreparably damaged. Which of the following should the nurse prioritize during the patients immediate postoperative recovery?
- A. Teaching the patient about options for eye prostheses
- B. Teaching the patient to estimate depth and distance with the use of one eye
- C. Assessing and addressing the patients emotional needs
- D. Teaching the patient about his post-discharge medication regimen
Correct Answer: C
Rationale: Emotional support is critical after unexpected enucleation due to trauma. Teaching about prostheses, depth perception, or medications is important but secondary in the immediate postoperative period.
A patient has informed the home health nurse that she has recently noticed distortions when she looks at the Amsler grid that she has mounted on her refrigerator. What is the nurses most appropriate action?
- A. Reassure the patient that this is an age-related change in vision.
- B. Arrange for the patient to have her visual acuity assessed.
- C. Arrange for the patient to be assessed for macular degeneration.
- D. Facilitate tonometry testing.
Correct Answer: C
Rationale: Amsler grid distortions suggest macular degeneration, requiring prompt ophthalmologic evaluation. They are not age-related, and visual acuity or tonometry tests are less relevant.
The nurse on the medicalsurgical unit is reviewing discharge instructions with a patient who has a history of glaucoma. The nurse should anticipate the use of what medications?
- A. Potassium-sparing diuretics
- B. Cholinergics
- C. Antibiotics
- D. Loop diuretics
Correct Answer: B
Rationale: Cholinergics, like pilocarpine, increase aqueous outflow in glaucoma treatment. Diuretics and antibiotics are not used for glaucoma management.
A patient who presents for an eye examination is diagnosed as having a visual acuity of 20/40. The patient asks the nurse what these numbers specifically mean. What is a correct response by the nurse?
- A. A person whose vision is 20/40 can see an object from 40 feet away that a person with 20/20 vision can see from 20 feet away.
- B. A person whose vision is 20/40 can see an object from 20 feet away that a person with 20/20 vision can see from 40 feet away.
- C. A person whose vision is 20/40 can see an object from 40 inches away that a person with 20/20 vision can see from 20 inches away.
- D. A person whose vision is 20/40 can see an object from 20 inches away that a person with 20/20 vision can see from 40 inches away.
Correct Answer: B
Rationale: 20/40 vision means the patient sees at 20 feet what a person with 20/20 vision sees at 40 feet, indicating reduced acuity. The measurement uses feet, not inches.